Estimating the Seroincidence of Melioidosis, Typhoid Fever and Scrub Typhus from Cross-sectional Serosurveys

摘要/摘要 这是加州大学戴维斯分校和马希多尔颁发的国际研究科学家发展奖(K01)的导师 泰国大学将支持流行病学助理教授Kristen Aiemjoy博士建立 有效、独立的全球卫生研究计划正在开发血清流行病学工具，以测量和 减轻全球传染病负担。在泰国，优先的研究需求是可扩展的工具，以 了解人群水平对急性发烧病因的负担，急性未分化发烧是 全国第二大就医原因。为了满足这一需要，本K01的范围是评估 创新和实用的血清流行病学工具来表征三种病因的人口水平负担 急性未分化性发热：斑疹伤寒、类鼻疽病和伤寒。具体目标是： 为斑疹伤寒和类鼻疽病建立纵向抗体反应模型，并估计抗体反应峰值， 衰减率、衰变形状和目标1B)以确定抗体反应是否随年龄变化；目标2) 建立一种分析方法来估计斑疹伤寒、类鼻疽病和伤寒的血清发病率 来自横断面调查数据；以及目标3)量化学校引起的选择偏差的程度- 在估计丛林斑疹伤寒发病率时， 类鼻疽和伤寒。研究战略的数据来源包括现有的纵向数据 已确诊的类鼻疽、丛林斑疹伤寒和伤寒病例；高维模拟数据；以及预期 泰国东北部农开省人口水平的血清学调查。研究的目的是与 培训目标旨在为艾姆乔伊博士提供必要的技能和经验，以建立一个独立的 全球健康研究计划。具体的培训目标是：1)掌握技术熟练程度 与血清流行病学有关的斑疹伤寒、肠热病、类鼻疽病感染的基础免疫学；2) 为血清学数据建立创新的分析方法和计算工具方面的专业知识；以及3)培养 成为独立的全球卫生机构所必需的领导力、专业技能和研究伙伴关系 研究科学家。培训计划将由Narisara博士领导的经验丰富的导师团队指导 Chantratita(Mahidol大学首席共同导师)，全球公认的类鼻疽免疫学领导者， 在泰国从事了30多年的临床和实验室传染病研究。杰森·安德鲁斯博士(主要合作伙伴 Mentor，斯坦福大学)，一位在统计推断和数学建模方面有专长的临床科学家， 将为评估热带传染病的诊断和干预措施提供指导。经久不衰 由IRSDA-K01支持的实地经验和协作研究，加上强大的机构 加州大学戴维斯分校(UCD公共卫生科学和专业发展主席波洛克博士)的支持 Mentor)，将与Aiemjoy博士和Mahidol大学建立持续的国际研究伙伴关系 旨在减轻泰国和全球的传染病负担。

SUMMARY/ABSTRACT This mentored International Research Scientist Development Award (K01) from UC Davis and Mahidol University-Thailand will support Dr. Kristen Aiemjoy, Assistant Professor of Epidemiology, to establish an impactful, independent global health research program developing seroepidemiologic tools to measure and reduce the burden on infectious diseases globally. In Thailand, a priority research need is scalable tools to understand the population-level burden for etiologies of acute fever, with acute undifferentiated fever being the second-leading cause of care-seeking nationwide. To meet this need, the scope of this K01 is to evaluate innovative and pragmatic seroepidemiologic tools to characterize the population-level burden of three etiologies of acute undifferentiated fever: scrub typhus, melioidosis, and typhoid fever. The Specific Aims are Aim 1A) To model longitudinal antibody responses for scrub typhus and melioidosis and estimate peak antibody response, decay rate, and decay shape, and Aim 1B) To determine if antibody responses vary according to age; Aim 2) To develop an analytic approach for estimating the seroincidence of scrub typhus, melioidosis and typhoid fever from cross-sectional survey data; and Aim 3) To quantify the magnitude of selection bias induced by a school- based sample relative to a random population-based sample when estimating the incidence of scrub typhus, melioidosis, and typhoid fever. Data sources for the research strategy include existing longitudinal data from confirmed melioidosis, scrub typhus, and typhoid fever cases; high-dimensional simulated data; and prospective population-level serosurveys in Nong Khai province in Northeast Thailand. The research aims are paired with training goals designed to provide Dr. Aiemjoy with the skills and experiences necessary to build an independent global health research program. The specific training goals are to 1) acquire technical proficiency in the fundamental immunology of scrub typhus, enteric fever, melioidosis infections relevant for seroepidemiology; 2) establish expertise in innovative analytic approaches and computation tools for serologic data; and 3) cultivate the leadership, professional skills, and research partnerships necessary to become an independent global health research scientist. The training plan will be guided by a team of experienced mentors led by Dr. Narisara Chantratita (primary co-mentor, Mahidol University), a globally recognized leader in melioidosis immunology with over 30 years of clinical and laboratory infectious disease research in Thailand. Dr. Jason Andrews (primary co- mentor, Stanford University), a clinical scientist with expertise in statistical inference and mathematical modeling, will provide mentorship to evaluate diagnostics and interventions for tropical infectious diseases. The prolonged field experience and collaborative research supported by this IRSDA-K01, coupled with strong institutional support from UC Davis (Dr. Pollock, UCD Chair of Public Health Sciences and professional development mentor), will cultivate a sustained international research partnership with Dr. Aiemjoy and Mahidol University aimed at reducing the burden of infectious disease in Thailand and Globally.